Body image has implications for child and adolescent well-being. Schools have been positioned as a suitable site to provide body image education and support the development of body image; however, little is known about the role of physical education in body image education. The aim of this study was to systematically review the evidence on the content and effectiveness of physical education-based body image or body-focused programmes published between 2000 and 2021. Using seven databases (Web of Science, SCOPUS, EBSCO, PsycINFO, MEDLINE, Science Direct, and SportDiscus), a total of 1185 non-duplicated articles were retrieved. The articles were selected using the following inclusion criteria: (a) intervention, programme or curriculum based in physical education that explores body image or related phenomena, (b) focused on children or young people, aged 18 years or younger, (c) conducted between 2000 and 2021, (d) quantitative and/or qualitative methods: and (e) published in English. Following the screening process, a total of 19 articles were included in this review. Results showed that most programmes reported successful outcomes, yet there was no consistent approach to the programme design and delivery. Physical activity and fitness-based programmes were the most frequently used intervention type, followed by critical sociocultural perspectives and programmes focused on movement experiences and body functionality. Whilst fitness-based programmes were generally effective in improving body image and related phenomena, future research should explore the mechanisms associated with these changes and further consider how sociocultural perspectives can be used to support body image programmes.